Miss Migraine Gets Angry

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. This post appeared first on my blog of the same name on November 21, 2012.

When my husband got laid off in September 2012, we had to purchase our own health insurance (Note: This was pre-ACA). This was not an easy task. I had to make sure to get a plan that had reasonable specialist co-pays, that covered all of our medications, that included chiropractic and behavioral services, AND that didn’t cost a million dollars. Overall, I’m pretty satisfied with the insurance. It’s not cheap and it’s not as good as what we had under my husband’s job, but it does what we need it to do.

Except when it comes to my abortive medication, namely, Maxlt.

Oh, sure, the insurance company says, we’ll let you refill that–but you only get nine pills (yes, we know your doctor prescribed you twelve pills per month) and we’re going to charge you $280! But wouldn’t you rather just take Imitrex? I mean, we’d really like you to take Imitrex. We think it’s way better than Maxlt. And you can trust us, even though we aren’t doctors or nurses. We’re an insurance company! We know what we’re doing!

(In case it wasn’t clear, the above paragraph was sarcasm.)

I knew that when I started this blog, and decided to sub-title it “A Girl’s Adventures in the United States of Pain,” that I was eventually going to have to talk about how ridiculous and (pardon my French) fucked up our healthcare situation is.

The Affordable Care Act is making things better for a lot of people, me included. Making insurance companies provide birth control with no copay is a huge thing. But what the Affordable Care Act does NOT do is force insurance companies to cover non-birth control prescriptions at a reasonable co-pay.

Let’s just say I’m furious.

I was even more furious when I called the insurance company and asked for the reason for the quantity limit. FDA regulation, they told me. Well, that’s blatantly false! Teri Robert covers this issue in her book Living Well With Migraine Disease, but basically, the FDA suggests a max of 3 pills per week to avoid rebound headaches. That works out to 12 pills per month.

My doctor’s office has clearly run into this problem many times. When I called them, they said they would send a form over asking for coverage and a quantity increase, and that it was almost always granted. This is definitely good news, but just because I will probably get the medication I need doesn’t mean I’m going to stop fighting this.

Living with migraines is a kind of hell. No one should have to suffer through more hoops and stupid red tape because an insurer wants to save a few bucks. On Monday, I’m going to be making a few phone calls.

Post script: This has since happened to me many more times. Now my co-pay for my abortive medication is $80 for 12 pills, and my new insurance company also tried to limit me to 9, citing the same “FDA regulation” as the previous one. Sigh.

Miss Migraine: Emergency room averse

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine (and other crap).

Saturday I had to go to the emergency room. I’m fine now, but I experienced a sudden and extreme pain in my lower right abdomen that was anything but normal. In this situation you’d think my biggest concern would be OH GODDESS AM I GOING TO DIE THIS FUCKING HURTS, but no. My biggest fear was that they’d tell me there was nothing wrong and I was “exaggerating” my pain or something like that.

I knew something was wrong. The pain started out like a bad menstrual cramp but quickly escalated to “I cannot stand up straight my insides are on fire what is happening.” The pain was definitely in my right ovary, and I thought perhaps a cyst had burst (nope–endometriosis, but I was right about the ovary part). Probably something you should go see a doctor about, right?

But so many times I’ve seen a doctor, or gone to the ER with a severe migraine that’s lasted five days, and they’ve said “Oh, it’s just stress, here are some muscle relaxers/Vicodin.” (Muscle relaxers and narcotics, by the way, don’t help migraines. At all.).

Or I’ve gone and said, “Hey, you can look this up on your fancy computer because we live in the future and all my medical records are digital, but my migraine specialist said I should go to the ER if X happens, and X has happened, and she’d like me to get an MRI,” only to be told “Whatever, it’s just stress, but we’ll do a CT scan just to be sure!” Real helpful, doc.

Once, before I was diagnosed with chronic migraine, an ER doctor pressed so hard into the back of my neck I started crying. I went in because I’d had a headache for a month straight, and none of my regular doctors had any ideas. Urgent care wasn’t a thing yet. He was trying to “prove” I had a tension headache and just needed to “relax.” Nevermind that neck pain and soreness is often a symptom of migraine, AND ALSO he pressed so hard it would have hurt even if I didn’t have a migraine!

ER doctors, especially male ER doctors, have a history of dismissing my pain and not listening to what I say about my own body. So, you can understand why I was hesitant to go to the ER despite the awful stabby pain in my right ovary.

Thankfully, and to the credit of the staff at UPMC Shadyside, the doctors who treated me listened, were kind, and even *gasp* got me a diagnosis. So, bad news–I have endometriosis. But good news–my ER experience didn’t lead me to murder anyone! The next step is to follow up with my lady parts doctor. In the meantime, I’m still in some pain, but no where near the level I was on Saturday.

Onward, I guess?

Miss Migraine: The United States of Pain

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. A version of this post appeared first on August 4, 2012, on my blog of the same name.

This is the complete drawing of the image I used as my header image. I did this sketch over top a blank map of the United States. I’m not trying to infer anything about any actual states — just representing the (metaphorical) country that I live in.